Jerusalem, 3 November, 2026 (TPS-IL) — Israelis are smoking a little less, but the gains are being overshadowed by worsening trends in obesity, diabetes and mental health, according to the latest annual report on the quality of community healthcare. The findings, published Tuesday, show a country where health outcomes depend heavily on where people live and how much they earn.

The report comes from the National Program for Quality Indicators in Community Healthcare, led by the Israel National Institute for Health Policy Research. It draws on data from all four HMOs and covers 2025, a year shaped by continued fighting in Gaza and the war with Iran.

Smoking was among the few areas to show modest progress. The share of smokers fell slightly, though the decline masks stark differences between communities. Bat Yam recorded the highest smoking rates in the country, with about one in three men in the city lighting up. It also had the highest rate among women of any city examined. Modi’in and Bnei Brak had the lowest rates. Class matters as well: men in lower socioeconomic groups are nearly twice as likely to smoke as men in affluent ones.

The picture is less encouraging elsewhere. Childhood obesity reached its highest level since tracking began. Among seven-year-olds, 8.6 percent were classified as obese in 2025. The gap between cities was dramatic. In Ashkelon, 13.1 percent of children that age were affected, compared with just 4.4 percent in Bnei Brak, a difference of nearly threefold.

Adults fare little better. More than half of Israel’s adult population is overweight or obese, with the highest rates concentrated in the south and the western Negev. Tel Aviv posted the lowest adult obesity rates. There was one bright spot: obesity declined moderately among teenagers and older adults.

Obesity and diabetes tend to travel together, and the report shows both are firmly entrenched. More than 676,000 Israelis now live with diabetes, over one in ten adults. Among diabetes patients under 65, more than half are obese. Geography again plays a role. In the Nazareth subdistrict, 14.7 percent of residents have diabetes, almost 70 percent above the rate in the Tel Aviv subdistrict. Nazareth also leads in the share of patients whose disease is poorly controlled.

Treatment, however, is advancing. Use of newer diabetes drugs has risen sharply, including GLP-1 medications such as Ozempic and Mounjaro, as well as drugs from the SGLT-2 inhibitor family. In 2025, more than 75 percent of diabetes patients aged 18 to 84 who had kidney damage received at least one drug from these groups. Researchers suggested the wider use of these medications may be contributing to better outcomes, including lower obesity among older diabetes patients, but stressed that the data cannot establish a direct causal link.

Mental health indicators moved in the wrong direction. Purchases of antidepressants have risen 14 percent since 2022, with the Tel Aviv subdistrict and the western Negev leading the trend. Haifa topped the list for purchases of sleep and sedative medications, at twice the rate seen in the Golan.

Cancer screening revealed some of the sharpest regional disparities. Jerusalem ranked last in the country on all three key measures: mammograms for breast cancer, screening for colorectal cancer, and tests for cervical cancer. Follow-up is also a problem. About a third of people who tested positive on the stool blood test for colorectal cancer did not complete a colonoscopy within six months (A positive result does not necessarily mean cancer, but it does call for further investigation).

For the first time, the report examined children’s dental health, and the results were troubling. Nearly half of six-year-olds and more than half of 12-year-olds had not seen a dentist for a routine checkup in the previous two years. Ramat Gan and Rehovot led in dental visits, while Safed, Jerusalem and the Golan sat at the bottom. Adult flu vaccination followed a similar pattern, with Holon and Ashkelon at the bottom of the national ranking.

Prof. Ronit Calderon-Margalit of the Hebrew University-Hadassah School of Public Health, who heads the program, said the year brought some encouraging developments alongside clear deterioration in obesity, diabetes and mental health. On the positive side, cervical cancer screening rose, and diabetes control improved. But she called the gaps between population groups especially worrying, pointing to Arab children, who face high rates of both obesity and tooth decay.

Prof. Nachman Ash, chair of the institute, said the childhood obesity figures should be read as an early warning of illness to come. He urged the next government to make narrowing health inequalities a top priority, arguing that looming budget pressures make it all the more important to protect health system funding. The system, he said, should not become a casualty of its own success in coping with emergencies.

The report’s central message is that national averages hide as much as they reveal. A child’s weight, a patient’s blood sugar and a woman’s chance of being screened for cancer all appear to depend heavily on zip code and income. With obesity and diabetes still rising and a new government on the horizon, the question is whether narrowing those gaps will become a real policy goal or remain a recurring finding in the annual report.